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    Summary
    EudraCT Number:2019-003343-29
    Sponsor's Protocol Code Number:ACP-103-064
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2019-11-06
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2019-003343-29
    A.3Full title of the trial
    A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Pimavanserin as Adjunctive Treatment for the Negative Symptoms of Schizophrenia (ADVANCE 2)
    Estudio en fase III, aleatorizado, doble ciego y controlado con placebo para evaluar la eficacia y la seguridad de pimavanserina como tratamiento complementario para los síntomas negativos de la esquizofrenia (Advance-2)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A phase 3 study to Evaluate the Efficacy and Safety of Pimavanserin for the Treatment of Schizophrenia
    Estudio en fase III para evaluar la eficacia y la seguridad de pimavanserina para tratamiento de esquizofrenia (Advance-2)
    A.3.2Name or abbreviated title of the trial where available
    ADVANCE 2
    ADVANCE 2
    A.4.1Sponsor's protocol code numberACP-103-064
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorACADIA Pharmaceuticals Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportACADIA Pharmaceuticals Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationACADIA Pharmaceuticals Inc.
    B.5.2Functional name of contact pointDaryl DeKarske
    B.5.3 Address:
    B.5.3.1Street Address3611 Valley Centre Drive, Suite 300
    B.5.3.2Town/ citySan Diego
    B.5.3.3Post codeCA 92130
    B.5.3.4CountryUnited States
    B.5.4Telephone number18583208683
    B.5.6E-mailddekarske@ACADIA-Pharm.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namePimavanserin
    D.3.2Product code ACP-103
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPimavanserin
    D.3.9.1CAS number 706782-28-7
    D.3.9.2Current sponsor codeACP-103
    D.3.9.3Other descriptive namePIMAVANSERIN TARTRATE
    D.3.9.4EV Substance CodeSUB128275
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namePimavanserin
    D.3.2Product code ACP-103
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPimavanserin
    D.3.9.1CAS number 706782-28-7
    D.3.9.2Current sponsor codeACP-103
    D.3.9.3Other descriptive namePIMAVANSERIN TARTRATE
    D.3.9.4EV Substance CodeSUB128275
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namePimavanserin
    D.3.2Product code ACP-103
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPimavanserin
    D.3.9.1CAS number 706782-28-7
    D.3.9.2Current sponsor codeACP-103
    D.3.9.3Other descriptive namePIMAVANSERIN TARTRATE
    D.3.9.4EV Substance CodeSUB128275
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number17
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Schizophrenia
    Esquizofrenia
    E.1.1.1Medical condition in easily understood language
    Chronic, debilitating mental illness characterized by disturbances in thinking, emotional reaction, and behavior
    Enfermedad mental crónica y debilitante caracterizada por trastornos en el pensamiento, reacción emocional y comportamiento.
    E.1.1.2Therapeutic area Psychiatry and Psychology [F] - Mental Disorders [F03]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10039626
    E.1.2Term Schizophrenia
    E.1.2System Organ Class 10037175 - Psychiatric disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    • To evaluate the efficacy of pimavanserin compared with placebo in the adjunctive treatment of the negative symptoms of schizophrenia
    • Evaluar la eficacia de la pimavanserina en comparación con placebo en el tratamiento complementario de los síntomas negativos de la esquizofrenia.
    E.2.2Secondary objectives of the trial
    • To evaluate the effect of adjunctive pimavanserin compared with adjunctive placebo on personal and social performance, global impression of severity of illness, global improvement of symptoms of illness, and response to treatment in adults experiencing negative symptoms of schizophrenia
    • Evaluar el efecto de la pimavanserina complementaria en comparación con placebo complementario sobre el funcionamiento personal y social, la impresión global de la gravedad de la enfermedad, la mejoría global de los síntomas de la enfermedad y la respuesta al tratamiento en adultos que experimenten síntomas negativos de la esquizofrenia.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Male or female, ≥18 and ≤55 years of age at the time of Screening
    2. Able to understand and provide signed informed consent
    3. Able to sign and date a request for medical records and/or subject privacy form if applicable according to local regulations
    4. In the Investigator’s opinion, is able to understand the nature of the trial, follow protocol requirements, be willing to comply with study drug administration, and discontinue prohibited concomitant medications
    5. Has a caregiver or some other identified responsible person (e.g., family member, social worker, caseworker, or nurse) considered reliable by the Investigator in providing support to the subject to help ensure compliance with study treatment, study visits, and protocol procedures, and who is also able to provide input helpful for completing study rating scales
    6. Able to complete subject-reported outcome measures, can be reliably rated on assessment scales, and is willing to participate in audio recording of assessment scales
    7. Diagnosis of schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria (confirmed using a customized module of the Structured Clinical Interview for DSM-5, Clinical Trials Version [SCID 5 CT])
    8. Diagnosis of schizophrenia made ≥1 year prior to randomization
    9. Score ≥20 on the sum of the 7 PANSS Marder negative factor items at Screening and Baseline
    AND
    Score ≥4 on at least 3, or ≥5 on at least 2, of the 7 PANSS
    Marder negative factor items
    10. Score ≤22 on the sum of the 8 PANSS Marder positive factor items
    AND
    PANSS score where no more than two of the following items have a score of 4 and none of the following items has a score ≥5 at both Screening and Baseline:
    • P1 (delusions)
    • P3 (hallucinatory behavior)
    • P6 (suspiciousness/persecution)
    11. A Clinical Global Impression of Schizophrenia Scale–Severity (CGI-SCH-S) for the negative symptoms of schizophrenia score ≥4 (moderately ill or worse) at Screening and Baseline
    12. Has been treated with an adequate dose of an antipsychotic within the dose range recommended according to the local prescribing information for at least 8 weeks prior to Screening and remaining at the same dose during the Screening Period
    13. The antipsychotic with which the subject is being treated must be one of the antipsychotics listed below:
    • Aripiprazole
    o Aripiprazole long-acting injectables
    o Abilify Maintena®
    • Aristada®
    • Asenapine
    • Brexpiprazole
    • Cariprazine
    • Lurasidone
    • Olanzapine
    • Risperidone
    • Risperidone long-acting injection
    14. If taking an oral antipsychotic, no dose change within 4 weeks prior to Screening or during the Screening Period
    15. If taking a long-acting injectable antipsychotic, no dose change within 16 weeks prior to Screening or during the Screening Period
    16. If taking an antidepressant medication or an anxiolytic medication, no dose change within 4 weeks of Screening or during the Screening Period (see also Appendix A for restrictions/prohibitions during the study)
    17. Must be medically stable and has been medically stable for at least 12 weeks prior to Screening, in the opinion of the Investigator
    18. If the subject is female, she must not be pregnant or breastfeeding. She must also be of non-childbearing potential (defined as either surgically sterilized or at least 1 year postmenopausal) OR must agree to use TWO clinically acceptable methods of contraception, if sexually active, throughout the study and for at least 1 month prior to the Baseline visit (Visit 2), and for 41 days following completion of the study.
    Acceptable methods of contraception include the following:
    a. Condom, diaphragm, or cervical cap with spermicide
    b. Hormonal contraception, including oral, injectable, transdermal, or implantable methods
    c. Intrauterine device (IUD)
    Only one of the two clinically acceptable methods can be a hormonal method.
    All female subjects must have a negative serum human chorionic gonadotropin (hCG) pregnancy test at Screening and a negative urine pregnancy test at Baseline.
    Note: Specific contraceptive methods are not required for male subjects with partners of childbearing potential, but may be used as a general precaution.
    1. Hombre o mujer con una edad comprendida entre ≥18 y ≤55 años en el momento de la selección.
    2. Es capaz de comprender y dar su consentimiento informado firmado.
    3. Es capaz de firmar y fechar una solicitud de historia clínica y/o del formulario de privacidad del sujeto, si procede de acuerdo con las normativas locales
    4. En opinión del investigador, es capaz de entender la naturaleza del ensayo, seguir los requisitos del protocolo, está dispuesto a cumplir con la administración del fármaco del estudio y a interrumpir la medicación concomitante prohibida.
    5. Tiene un cuidador o alguna otra persona responsable identificada (p. ej., familiar, trabajador social, asistente social o personal de enfermería) considerada fiable por el investigador en la provisión de apoyo al paciente para ayudar a garantizar el cumplimiento del tratamiento del estudio, las visitas del estudio y los procedimientos del protocolo y que también es capaz de proporcionar información útil para completar las escalas de valoración del estudio.
    6. Es capaz de completar las medidas de resultados comunicados por el sujeto, puede evaluarse de manera fiable en las escalas de evaluación y está dispuesto a participar en el registro de audio de las escalas de evaluación.
    7. Diagnóstico de esquizofrenia según el Manual diagnóstico y estadístico de los trastornos mentales, 5.ª edición (DSM-5), confirmado por un módulo personalizado de la Entrevista clínica estructurada para DSM-5, versión para ensayos clínicos (SCID-5-CT).
    8. Diagnóstico de la esquizofrenia realizado ≥1 año antes de la aleatorización.
    9. Puntuación ≥20 en la suma de los 7 ítems del factor negativo de Marder de la PANSS en la selección y el inicio
    Y
    Puntuación de ≥4 en al menos 3, o de ≥5 en al menos 2, de los 7 ítems de factores negativos de la PANSS.
    10. Puntuación ≤22 en la suma de los 8 ítems de factores positivos de Marder de la PANSS
    Y
    Puntuación PANSS en la que no más de dos de los siguientes ítems tengan una puntuación de 4 y ninguno de los siguientes ítems tenga una puntuación ≥5, tanto en la selección como al inicio:
    • P1 (delirios)
    • P3 (conducta alucinatoria)
    • P6 (desconfianza/persecución)
    11. Una puntuación en la Escala de impresión clínica global de la esquizofrenia: gravedad (CGI-SCH-S) para los síntomas negativos de la esquizofrenia ≥4 (enfermedad moderada o peor) en la selección y el inicio.
    12. Ha sido tratado con una dosis adecuada de un antipsicótico con un intervalo de dosis recomendado de acuerdo con la ficha técnica local durante al menos 8 semanas antes de la selección y ha tenido la misma dosis durante el periodo de selección.
    13. El antipsicótico con el que el sujeto está recibiendo tratamiento debe ser uno de los antipsicóticos que se enumeran a continuación:
    • Aripiprazol
    o Inyectables de aripiprazol de acción prolongada
    o Abilify Maintena ®
    • Aristada ®
    • Asenapina
    • Brexpiprazol
    • Cariprazina
    • Lurasidona
    • Olanzapina
    • Risperidona
    • Inyección de risperidona de acción prolongada
    14. Si está tomando un antipsicótico por vía oral, no se ha producido ningún cambio de dosis en las 4 semanas anteriores a la selección o durante el periodo de selección.
    15. Si está tomando un antipsicótico inyectable de acción prolongada, no se ha producido ningún cambio de dosis en las 16 semanas anteriores a la selección o durante el periodo de selección.
    16. Si está tomando un fármaco antidepresivo o ansiolítico, no se ha producido ningún cambio de dosis en las 4 semanas previas a la selección o durante el periodo de selección (consulte también en la Apéndice A las restricciones/prohibiciones durante el estudio).
    17. Deben ser estable médicamente y haberlo estado durante al menos 12 semanas antes de la selección, en opinión del investigador.
    18. Si el sujeto es mujer, no debe estar embarazada ni en periodo de lactancia. Además, la paciente no debe tener capacidad de concebir (lo que se define como estar esterilizada quirúrgicamente o ser posmenopáusica durante al menos 1 año) O debe aceptar el uso de DOS métodos anticonceptivos clínicamente aceptables, si es sexualmente activa, durante todo el estudio y al menos 1 mes antes de la visita inicial (visita 2) y durante 41 días después de la finalización del estudio.
    Los métodos anticonceptivos aceptables incluyen los siguientes:
    a. preservativo, diafragma o capuchón cervical con espermicida;
    b. anticonceptivos hormonales, incluidos los orales, inyectados, transdérmicos o métodos implantables;
    c. dispositivo intrauterino (DIU).
    Solo uno de los dos métodos clínicamente aceptables puede ser un método hormonal.
    Todas las participantes deben tener un resultado negativo en la prueba de embarazo de gonadotropina coriónica humana (hCG) en suero en la selección y una prueba de embarazo en orina negativa al inicio.
    Nota: No son necesarios métodos anticonceptivos específicos para los sujetos varones con parejas en edad fértil, pero se pueden usar como medida de precaución general.
    E.4Principal exclusion criteria
    1. Based on the SCID-5-CT, has a current comorbid psychiatric disorder other than schizophrenia (e.g., bipolar disorder, obsessive compulsive disorder, substance abuse) or a disorder that would interfere with the ability to complete study assessments (e.g., intellectual disability)
    2. Score ≥2 for two or more movements or a score of 3 or 4 for any single movement on the Abnormal Involuntary Movement scale (AIMS)
    3. Total score ≥2 on the Barnes Akathisia Rating Scale (BARS)
    4. Total score ≥5 on the Simpson-Angus Extrapyramidal Side Effects Scale (SAS)
    5. Calgary Depression Scale for Schizophrenia (CDSS) score ≥9 at both Screening and Baseline
    6. Is at a significant risk of suicide (e.g., answers “Yes” to suicidal ideation question 4 or 5 [current or over last 6 months] or answers “Yes” to suicidal behavior questions on the C-SSRS [over last 6 months]), in the opinion of the Investigator
    7. Has a significant risk of violent behavior in the opinion of the Investigator
    8. Has met DSM-5 criteria for substance use disorders within the last 6 months prior to randomization (other than caffeine and/or nicotine)
    9. A urine drug screen result at Screening or Baseline that indicates the presence of any tested prohibited substance of potential abuse, except marijuana
    • Subjects with a result indicating the presence of marijuana are permitted, if allowed by local regulations, if they agree to abstain from marijuana use during the study and the Medical Monitor approves the subject’s participation
    10. Subject was treated with two or more antipsychotics, for any indication, within 8 weeks prior to Screening
    11. Laboratory testing confirms the absence of the main antipsychotic
    12. Is taking a medication or drug or other substance that is prohibited according to this protocol, including medications that prolong the QT interval, strong cytochrome P450 (CYP) 3A4 enzyme (CYP3A4) inhibitors and inducers
    13. Known family or personal history or symptoms of long QT syndrome or risk factors for torsade de pointes and/or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval
    14. Has an ECG result at Screening or Baseline that meets one of the following exclusionary conditions:
    • If QRS interval <120 ms then a QTcF ≥460 ms is exclusionary
    • If QRS interval ≥120 ms then a QTcF ≥480 ms is exclusionary
    15. Current evidence, or history within the previous 12 weeks prior to Screening, of a serious and/or unstable psychiatric, neurologic, cardiovascular, respiratory, gastrointestinal, renal, hepatic, hematologic, or other medical disorder, including cancer or malignancies that in the judgment of the Investigator would jeopardize the safe participation of the subject in the study
    16. Has moderate to severe congestive heart failure (New York Heart Association [NYHA] class III and class IV)
    17. Has a history of myocardial infarction within 6 months prior to enrollment
    18. Has a history of uncontrolled diabetes mellitus (DM), Type 1 or 2 DM requiring insulin treatment, or glycosylated hemoglobin (HbA1c) >7% at Screening
    19. Has a clinically significant thyroid function test result at Screening
    20. Has clinically significant laboratory abnormalities that in the judgment of the Investigator or Medical Monitor would jeopardize the safe participation of the subject in the study
    21. Known to be positive for hepatitis C virus (HCV) or human immunodeficiency virus (HIV)
    22. Has a body mass index (BMI) <19 or ≥35 at Screening
    23. Has a history of neuroleptic malignant syndrome
    24. Is breastfeeding or lactating
    25. Has a significant sensitivity or allergic reaction to pimavanserin or its excipients
    26. Has previously been randomized in any prior clinical study with pimavanserin, and/or received any other investigational (either approved or unapproved) drug within 30 days or 5 half-lives (whichever is longer) prior to Screening
    27. Has any condition that, in the opinion of the Investigator, would interfere with the ability to comply with study instructions, or that might confound the interpretation of the study results or put the subject at undue risk
    28. Is an employee of ACADIA, or has a family member who is an employee of ACADIA
    29. Has participated in >2 pharmaceutical clinical research studies within the previous 2 years
    30. Subject is judged by the Investigator or the Medical Monitor to be inappropriate for the study
    31. Subject has had a social hospitalization, defined as admission to the hospital as a result of inadequate family support or care at the subject’s primary residence, during the 8 weeks prior to screening
    1.Teniendo en cuenta SCID-5-CT, tiene trastorno psiquiátrico concomitante actual distinto de la esquizofrenia o un trastorno que puede interferir con la capacidad para completar las evaluaciones del estudio
    2.Puntuación ≥2 en dos o más movimientos o una puntuación de 3 o 4 para cualquier movimiento individual en Escala de movimientos involuntarios anormales (AIMS).
    3.Puntuación total ≥2 en Escala de evaluación de la acatisia de Barnes (BARS).
    4.Puntuación total ≥5 en Escala de efectos secundarios extrapiramidales de Simpson-Angus (SAS).
    5.Puntuación≥9 en Escala de depresión de Calgary para la esquizofrenia (CDSS), tanto en selección como inicio.
    6.Tiene riesgo significativo de suicidio (ej:respuestas “Sí” a pregunta 4 o 5 sobre pensamientos suicidas [actual o durante últimos 6 meses) o respuestas “Sí” a preguntas sobre conductas suicidas en C-SSRS [en últimos 6 meses]), en opinión del investigador.
    7.Tiene riesgo significativo de comportamiento violento, en opinión del investigador.
    8.Ha cumplido los criterios del DSM-5 para trastornos por consumo de drogas en los últimos 6 meses antes de aleatorización (aparte de cafeína y/o nicotina).
    9.Un resultado de prueba de detección de drogas en orina en selección o inicio que indica presencia de cualquier posible consumo de las sustancias prohibidas analizadas, excepto marihuana. Son aptos sujetos con resultado que indique presencia de marihuana, si lo permite la normativa local, si aceptan abstenerse de consumirla durante el estudio y el supervisor médico aprueba la participación del sujeto.
    10.El sujeto fue tratado con dos o más antipsicóticos, para cualquier indicación, en las 8 semanas anteriores a selección.
    11.Los análisis confirman ausencia del antipsicótico principal.
    12.Está tomando medicación o fármaco u otra sustancia que esté prohibida de acuerdo con este protocolo, incluidos los medicamentos que prolongan el intervalo QT, inhibidores e inductores potentes del enzima 3A4 del citocromo P450 (CYP) (CYP3A4)
    13.Antecedentes personales o familiares conocidos o síntomas de síndrome de QT largo o factores de riesgo de torsade de pointes y/o muerte súbita, incluida bradicardia sintomática, hipopotasiemia o hipomagnesiemia y la presencia de prolongación congénita del intervalo QT.
    14.Resultado de ECG en selección o inicio que cumple una de las siguientes condiciones de exclusión: Si el intervalo QRS es <120ms, un QTcF≥460ms es motivo de exclusión. Si el intervalo QRS es ≥120ms, un QTcF≥480ms es motivo de exclusión.
    15.Indicios actuales o antecedentes en las 12 semanas previas a la selección de una enfermedad psiquiátrica grave y/o inestable, trastornos neurológicos, cardiovasculares, respiratorios, gastrointestinales, renales, hepáticos, hematológicos o cualquier otro trastorno médico, incluido el cáncer o las neoplasias malignas que, en opinión del investigador, podrían poner en peligro la seguridad de la participación del sujeto en el estudio.
    16.Insuficiencia cardiaca congestiva de moderada a grave (clases III o IV según la Asociación de Cardiología de Nueva York).
    17.Antecedente de infarto de miocardio en los 6 meses previos a la inscripción.
    18.Antecedentes de diabetes mellitus (DM) no controlada, DM de tipos 1 o 2 que requieren tratamiento con insulina o hemoglobina glucosilada (HbA1c)>7% en selección.
    19.Resultado de prueba de función tiroidea clínicamente significativo en selección.
    20.Anomalías de laboratorio clínicamente significativas que, en opinión del investigador o del supervisor médico, pueden poner en peligro la seguridad de la participación del sujeto en el estudio.
    21.Resultado positivo conocido en prueba de virus de hepatitis C (VHC) o virus de inmunodeficiencia humana (VIH).
    22.Índice de masa corporal (IMC)<19o≥35 en la selección.
    23.Antecedentes de síndrome neuroléptico maligno.
    24.Está dando el pecho o en periodo de lactancia.
    25.Sensibilidad significativa o reacción alérgica a pimavanserina o a sus excipientes.
    26.Ha sido aleatorizado previamente en algún estudio clínico anterior con pimavanserina y/o ha recibido cualquier otro fármaco en fase de investigación (ya sea o no autorizado) en un plazo de 30 días o 5 semividas (el que sea más largo) antes de la selección.
    27.Cualquier afección que, en opinión del investigador, podría interferir con la capacidad para cumplir con las instrucciones del estudio, podrían confundir la interpretación de los resultados del estudio o poner al sujeto en un riesgo indebido.
    28.Es un empleado de ACADIA o un miembro de su familia es un empleado de ACADIA.
    29.Ha participado en>2 estudios de investigación clínica farmacéutica en los 2 años anteriores.
    30.El sujeto es a juicio del investigador o supervisor médico inadecuado para el estudio.
    31.El sujeto se ha sometido a una hospitalización social, definida como un ingreso en el hospital como resultado de un cuidado o apoyo de su familia insuficiente en el domicilio principal del sujeto durante las 8 semanas anteriores a selección
    E.5 End points
    E.5.1Primary end point(s)
    • Change from Baseline to Week 26 in the Negative Symptom Assessment–16 (NSA 16) total score
    • Cambio desde el inicio hasta la semana 26 en la puntuación total de la Escala de evaluación de síntomas negativos: 16 ítems (NSA-16).
    E.5.1.1Timepoint(s) of evaluation of this end point
    from Baseline to Week 26
    desde el inicio hasta la semana 26
    E.5.2Secondary end point(s)
    Key Secondary Endpoint:
    • Change from Baseline to Week 26 in the Personal and Social Performance (PSP) scale score
    Other Secondary Endpoints:
    • Change from Baseline to Week 26 in the Clinical Global Impression of Schizophrenia Scale–Severity (CGI SCH S) of negative symptoms score
    • Clinical Global Impression of Schizophrenia Scale–Improvement (CGI SCH I) of negative symptoms score at Week 26
    • Change from Baseline to Week 26 in the Positive and Negative Syndrome Scale (PANSS) total score
    • Change from Baseline to Week 26 in PANSS subscores
    • Change from Baseline to Week 26 in PANSS Marder factor (negative symptoms) score
    • Change from Baseline to Week 26 in Brief Assessment of Cognition in Schizophrenia (BACS) score
    • Change from Baseline to Week 26 in Karolinska Sleepiness Scale (KSS) score
    Criterio de valoración secundario clave:
    • Cambio desde el inicio hasta la semana 26 en la puntuación de la Escala de funcionamiento personal y social (PSP).
    Otros criterios de valoración secundarios:
    • Cambio desde el inicio hasta la semana 26 en la puntuación de la Escala de impresión clínica global de la esquizofrenia: gravedad (CGI-SCH-S) de los síntomas negativos.
    • La puntuación de la Escala de impresión clínica global de la esquizofrenia: mejora (CGI-SCH-I) de los síntomas negativos en la semana 26.
    • Cambio desde el inicio hasta la semana 26 en la puntuación total de la Escala de los síndromes positivo y negativo (PANSS).
    • Cambio desde el inicio hasta la semana 26 en las subpuntuaciones de la escala PANSS.
    • Cambio desde el inicio hasta la semana 26 en la puntuación del factor Marder de la PANSS (síntomas negativos).
    • Cambio desde el inicio hasta la semana 26 en la puntuación de la Evaluación abreviada de la cognición en la esquizofrenia (BACS).
    • Cambio desde el inicio hasta la semana 26 en la puntuación de la Escala de somnolencia de Karolinska (KSS).
    E.5.2.1Timepoint(s) of evaluation of this end point
    from Baseline to Week 26
    desde el inicio hasta la semana 26
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA28
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Bulgaria
    Czech Republic
    Hungary
    Poland
    Russian Federation
    Serbia
    Spain
    Ukraine
    United States
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months6
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 386
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state16
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 180
    F.4.2.2In the whole clinical trial 386
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    At the end of participation in the trial, the study subjects will be asked for participation in a 52-week open label safety follow-up study (ACP-103-035)
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2020-01-08
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-11-29
    P. End of Trial
    P.End of Trial StatusOngoing
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